Texas health officials are taking steps to close Timberlawn psychiatric hospital after a child said she was raped there.

The state's move to revoke Timberlawn's license, announced Friday, is one of the strongest steps it can take against health care facilities. The unusual effort speaks to Timberlawn’s long history of safety problems: It was already the only psychiatric hospital on probation with the state.

The Dallas Morning News reported in October that police were investigating the sexual assault of a 13-year-old by another patient. Government safety inspectors then swarmed the hospital.

“We continued to see the same problems over and over again, some of them quite serious,” she said. “We have to hold hospitals accountable, especially when patient rights and safety are concerned."

The state has also threatened Timberlawn with a $600,000 fine.

The hospital’s chief executive, James Miller, said it plans to appeal. It successfully fought a similar shut-down effort in 2016, in part by paying a fine and agreeing to improve patient care.

Miller has previously denied that his hospital is unsafe and said he sees every inspection as an opportunity to improve.

History of problems

Timberlawn is the oldest standalone hospital for mentally ill patients in the Dallas area and has historically been one of the largest. It is owned by Universal Health Services, a $10 billion publicly traded company that operates hundreds of hospitals nationwide, including others in North Texas.

A 2016 data analysis by The News found that of 154 UHS hospitals, more than a quarter were plagued by serious safety problems.

A spokeswoman for Universal Health Services did not respond to a request for comment.

People go to Timberlawn for everything from depression to psychosis, whether they can afford to pay for treatment or not. But the hospital in eastern Dallas, which is licensed for 144 beds, has made headlines in recent years because of severe incidents.

During this time, hospital regulators cracked down on Timberlawn and even temporarily cut off its funding.

In the most recent incident, the 13-year-old girl said she was raped by a 17-year-old boy. The hospital had placed the teens in rooms just feet away from each other, even though the boy was at risk for sexual aggression.

The girl said the boy slipped into her room and raped her. “Do you think I’m pregnant?” she asked afterward, according to an inspection report.

The News does not typically name victims of sexual assault.

The teens were staying in a new environment that gave boys and girls easier access to one another, according to inspection documents and interviews with former staffers. Boys and girls used to be housed in separate wings at Timberlawn, The News found.

The situation was exacerbated by poor staffing, inspectors said. The night of the alleged rape, inspectors reported, the hospital had put 16 children under the watch of just one mental-health aide.

Inspectors also found that staff had failed in their responsibility to provide medical care: No plans were in place to treat the girl’s previous history of sexual abuse, or the boy’s sexual aggression. Staff also failed to check on 12 children who were at risk of suicide.

Legal and financial woes

After the latest safety violations, federal regulators said they would stop reimbursing Timberlawn for treating patients on Medicare and Medicaid, the government insurance for the poor, elderly and disabled, unless the hospital makes certain improvements.

Timberlawn is also facing lawsuits. The woman who said she was raped there in 2015 has sued; the hospital has denied wrongdoing in that case.

The family of the doctor who died there has also sued, alleging negligence; the hospital has not yet responded, according to court records. But a state spokeswoman has said an inspection found no safety violation.

If Timberlawn wants to stay open, it has until the end of January to appeal the state’s decision.

State officials say they did a top-to-bottom inspection of Timberlawn earlier this week. The findings are pending.